Clearinghouse Services Status

By TherapyNotes, LLC on May 10, 2024

Last updated: 5/10/24 at 6:45 PM ET 

A cyberattack against Change Healthcare caused all clearinghouse services to be shut down on 2/21/24. TherapyNotes has migrated claims and ERA features to CLAIM.MD, and we now fully support sending claims and receiving ERAs.

Can I send Claims now?

Yes, TherapyNotes can now send electronic claims to any payer in our payer list whether or not they require enrollment, assuming your enrollment has been completed.

Can I send claims to payers that require enrollment? Why are my claims stuck as “Pending”? And what is enrollment anyway?

Some payers require you to complete paperwork in order to send claims from a new clearinghouse. This is separate from ERA enrollment, which is always required. Do not confuse enrollment with credentialing. Credentialing with a payer means going in network with them.

The enrollment process for sending claims is quick and easy for most payers. There is a new streamlined process built into TherapyNotes to take these steps. This is significantly easier than what was required with Change Healthcare.

The TherapyNotes payer list has been updated to the CLAIM.MD payers and payer IDs instead of Change Healthcare's payer list. For new payer enrollments, submitted claims may initially sit in ‘Pending’ status for 72 hours to give your new enrollment request enough time to complete.

For questions on the new enrollment process, contact our enrollment support team at (215) 658-4550, option 4. Please do not contact CLAIM.MD directly for enrollment support. They are not able to assist and will direct you back to our TherapyNotes Support team.

How do I enroll if my practice has multiple clinicians with their own tax ID and group NPI?

The self-enrollment feature in TherapyNotes uses the practice's tax ID and group NPI from the practice settings. If you have a practice account shared by multiple clinicians (known as co-op practices) with their own tax ID and group NPI (such as in the clinician settings billing overrides), you will need to contact our enrollment team at (215) 658-4550, option 4, to help you complete your enrollment. 

PO Box Rejections

We are seeing many rejections due to the presence of a PO box in the address. If you see this rejection reason you need to remove your PO Box from Practice Information, Multiple Practice Locations, and Clinician Billing Setting Overrides. Instead you can put a PO Box in Alternate Billing Address in Practice Billing Settings.

Payer Specific Updates

  • Cigna: Cigna ERAs were not coming in for the past couple weeks, but we are now receiving them again. (5/10)
  • FrontPath Health Coalition (34171): You may have received rejections that state "DUE TO THE RECENT CYBERSECURITY INCIDENT, THERE IS NOT CURRENTLY AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER". The connection to this payer has been restored and you can resubmit these claims. (5/10)
  • Planned Administrators - Non Preferred Blue Providers (37287): You may have received rejections that state "DUE TO THE RECENT CYBERSECURITY INCIDENT, THERE IS NOT CURRENTLY AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER". The connection to this payer has been restored and you can resubmit these claims. (5/6)
  • ProviDRs Care Network (48100): You may have received rejections that state "WP481 Site is not allowed to send claims to the specified payer". The connection to this payer has been restored and you can resubmit these claims. (5/6)
  • Alicare (13550): It has been determined this payer requires Change Healthcare to process claims. While CLAIM.MD looks for an alternative connection route with this payer, you may receive rejections that state "Rejected, Claim Reason:Missing or invalid information. Additional Details: Code 21 - Entity's id number., PAYER ID IS EXPIRED {5403}". (5/1)
  • Advantek Benefit Administrators (83077): You may have received rejections that state "DUE TO THE RECENT CYBERSECURITY INCIDENT, THERE IS NOT CURRENTLY AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER". The connection to this payer has been restored and you can resubmit these claims. (4/29)
  • HealthPlan Services (59140): You may have received rejections that state "DUE TO THE RECENT CYBERSECURITY INCIDENT, THERE IS NOT CURRENTLY AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER". The connection to this payer has been restored and you can resubmit these claims. (4/26)
  • Employee Benefits Plan Administration, Inc. (03036): You may have received rejections that state "DUE TO THE RECENT CYBERSECURITY INCIDENT, THERE IS NOT CURRENTLY AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER". The connection to this payer has been restored and you can resubmit these claims. (4/24)
  • Passport Advantage (66008): You may have received rejections that state "DUE TO THE RECENT CYBERSECURITY INCIDENT, THERE IS NOT CURRENTLY AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER". The connection to this payer has been restored and you can resubmit these claims. (4/23)
  • Indiana ProHealth Network (35161): This payer was previously not accepting claims because they were dependent on Change Healthcare. They are now accepting claims again. (4/23)
  • Mississippi Physicians Care Network (64084): This payer was previously not accepting claims because they were dependent on Change Healthcare. They are now accepting claims again. (4/23)

Payers that Require Change Healthcare 

A number of payers are dependent on Change Healthcare and are therefore unable to receive claims. CLAIM.MD may hold these claims until the payer is able to receive them, but in some cases, you may get rejections and need to resubmit. As connections are restored, we will update the list. 

Payer Name Payer ID 
ADVANTICA BENEFITS 59374
Alacura Medical Transportation Management LLC RP065
Alicare  13550
Allegeant 52193
Alliant Health Plans of Georgia 58234
Amalgamated Life PA Alicare 13343
American Health Advantage of Florida 58379
American Healthcare Alliance 01066
American National Ins Co ANICO 74048
American Postal Workers Union He 44444
AmFirst Insurance Company 64090
ASA GEHA 06603
Associates for Health Care, Inc. (AHC) 36326
Atlantic Medical Insurance 22285
Bass Administrators, Inc. 38238
Benefit Management Inc 48611
Benefit Plan Administrators Co. Eau Claire, WI 39081
Benefit Risk Management Services 99320
BritCay 22286
CarePartners of Connecticut  16307
Careworks 10010
Consolidated Health Plans

87843

Cook Childrens Health Group

TH104

Crescent Health Solutions

56213

Encircle PPO

35206

Global Excel Management

GEM01

Harvard Pilgrim Stride Health Plan MA

04245

Health Payment Systems Inc

20270

Health Services for Children wit

37290

Healthsource ME

01041

HealthSource N TX Cigna

75255

Healthsource SC

06119

Heritage Consultants

59230

High Desert Medical Group

95393

HMA Hawaii

86066

Individual Health Insurance Comp

31053

JP Farley Corporation

34136

Keenan Associates CA

95279

Loma Linda University Adventist

37267

Lucent Health

88056

Managed Care Services LLC

35162

MBA Benefit Administrators Inc

83028

Midwest Health Partners

76079

Novasys Health Network

71080

OptiMed Health

96277

Patient Physician Cooperatives

20510

PHP TPA Services

30031

Prairie States Enterprises Inc

36373

Primary Health Network

82048

Rocky Mountain HMO

SX141

S S Healthcare Strategies

31441

Sanford Health Plans

91184/TP984

SANFORD HEALTH PLANS Repriced Claims

TP984

SelfFunded Plans Inc

34131

Southeastern Indiana Health SIHO

77153

St Therese Physician Association

37116

St. Vincent Catholic Medical Center - USFHP

13407

Superior Select Health Plan

61184

Trillium Health Resources

56089

TRUSTED HEALTH PLAN

L0230

Trusteed Plans Service Corporation

91078

UCare of Minnesota

SX178

Udelhoven Health Plan

92006

Unified Life Insurance Company

RP064

VOLUSIA HEALTH NETWORK

59266

Western Health Advantage

68039

Western Mutual Insurance

37247

Western Southern Financial Group

31048

 

Why aren't I getting ERAs? What happens to old ERAs I didn’t get?

TherapyNotes is receiving ERAs from CLAIM.MD and Change Healthcare. Enrollment is required, even if you were previously enrolled with Change Healthcare. In many cases, this is as simple as clicking a button. Sometimes, there is paperwork to complete, which is streamlined within TherapyNotes (No printing or faxing required). In some cases, you will be given instructions to follow on the payer’s website.

Change Healthcare is now sending us a backlog of old ERAs as well.

Some payers may be agreeable to resend ERAs to you. Practices are encouraged to call payers to make this request, but not until after you are enrolled to receive ERAs from CLAIM.MD.

Can I do eligibility checks or mail paper claims?

The ability to do eligibility checks and have the clearinghouse mail paper claims are not currently available but will be brought back in the future. You can still generate your own CMS-1500 forms within TherapyNotes and mail them on your own.

* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.

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